European journal of obstetrics, gynecology, and reproductive biology · 2006
White blood cell count as a predictor of the severity of sickle cell disease during pregnancy.
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Litos Michail, Sarris Ippokratis, Bewley Susan, Seed Paul, Okpala Iheanyi, Oteng-Ntim Eugene
Аннотация
OBJECTIVE: Increasing epidemiological evidence implicates leukocytosis as a major risk factor for poor outcome in non-pregnant sickle cell disease (SCD) patients. The aim of this study was to investigate whether steady-state white blood cell (WBC) count can predict SCD-related problems in pregnancy.
DESIGN: Retrospective observational study of 40 SCD pregnant women who had their antenatal care at Guy's & St Thomas' NHS Trust, London. Twenty-six women developed clinical complications related to SCD during their pregnancy (painful crisis, chest symptoms, infections, severe anaemia requiring blood transfusion, pre-eclampsia, and/or thromboembolism) and 14 remained asymptomatic. The steady-state leukocyte counts early in pregnancy were compared between the two groups and receiver operator characteristics (ROC) curve was plotted for different values of WBC.
RESULTS: Compared to asymptomatic patients, women who developed SCD-related complications had significantly higher total WBC count [11.2 x 10(9)L(-1) (SD 3.22) versus 8 x 10(9)L(-1) (2.8), p<0.01], higher lymphocyte count [3 x 10(9)L(-1) (1.62) versus 1.6 x 10(9)L(-1) (0.65), p<0.01] and higher monocyte count [0.8 x 10(9)L(-1) (0.47) versus 0.4 x 10(9)L(-1) (0.21), p<0.01]. The neutrophil count showed a similar trend but the difference did not reach statistical significance [6.6 x 10(9)L(-1) (2.29) versus 5.7 x 10(9)L(-1) (2.15), p=0.22]. The area under the ROC curve was 74% (95% CI: 56-92).
CONCLUSION: WBC count early in pregnancy was significantly higher in women who subsequently developed clinical problems related to SCD. The WBC may be used as a predictor of the severity of SCD in pregnancy.
DESIGN: Retrospective observational study of 40 SCD pregnant women who had their antenatal care at Guy's & St Thomas' NHS Trust, London. Twenty-six women developed clinical complications related to SCD during their pregnancy (painful crisis, chest symptoms, infections, severe anaemia requiring blood transfusion, pre-eclampsia, and/or thromboembolism) and 14 remained asymptomatic. The steady-state leukocyte counts early in pregnancy were compared between the two groups and receiver operator characteristics (ROC) curve was plotted for different values of WBC.
RESULTS: Compared to asymptomatic patients, women who developed SCD-related complications had significantly higher total WBC count [11.2 x 10(9)L(-1) (SD 3.22) versus 8 x 10(9)L(-1) (2.8), p<0.01], higher lymphocyte count [3 x 10(9)L(-1) (1.62) versus 1.6 x 10(9)L(-1) (0.65), p<0.01] and higher monocyte count [0.8 x 10(9)L(-1) (0.47) versus 0.4 x 10(9)L(-1) (0.21), p<0.01]. The neutrophil count showed a similar trend but the difference did not reach statistical significance [6.6 x 10(9)L(-1) (2.29) versus 5.7 x 10(9)L(-1) (2.15), p=0.22]. The area under the ROC curve was 74% (95% CI: 56-92).
CONCLUSION: WBC count early in pregnancy was significantly higher in women who subsequently developed clinical problems related to SCD. The WBC may be used as a predictor of the severity of SCD in pregnancy.